Scientific article

Abdominal surgery in patients with chronic noncirrhotic extra hepatic portal vein obstruction : A multicenter retrospective study

Published inHepatology
Publication date2024-04-29
First online date2024-04-29

Background aims: In patients with noncirrhotic chronic extra-hepatic portal vein obstruction (EHPVO), data on morbimortality of abdominal surgery are scarce.

Approach results: We retrospectively analyzed the charts of 76 patients (78 interventions) with EHPVO undergoing abdominal surgery within the VALDIG network. Fourteen percent of the patients had ≥1 major bleeding (unrelated to portal hypertension) and 21% had ≥1 Dindo-Clavien grade ≥3 postoperative complication within 1 month after surgery. Fifteen percent had ≥1 portal hypertension related complication within 3 months after surgery. Three patients died within 12 months after surgery. An unfavorable outcome (i.e. ≥1 above-mentioned complications or death) occurred in 37% of the patients and was associated with a history of ascites and with non-wall, non-cholecystectomy surgical intervention: 17% of the patients with none of these features had an unfavorable outcome, versus 48% and 100% when one or both features were present, respectively. We then compared 63/76 EHPVO patients with 126 matched (2:1) control patients without EHPVO but with similar surgical interventions. As compared with control patients, incidence of major bleeding (p<0.001) and portal-hypertension related complication (p<0.001) was significantly higher in patients with EHPVO, but not that of grade ≥3 postoperative complication nor of death. The incidence of unfavorable post-operative outcome was significantly higher in patients with EHPVO than in those without (33% vs. 18%, p=0.01).

Conclusion: Patients with EHPVO are at high-risk of major peri- or postoperative bleeding and postoperative complications, especially in those with ascites or undergoing surgery other than wall surgery or cholecystectomy.

Citation (ISO format)
ELKRIEF, Laure et al. Abdominal surgery in patients with chronic noncirrhotic extra hepatic portal vein obstruction : A multicenter retrospective study. In: Hepatology, 2024. doi: 10.1097/HEP.0000000000000901
Main files (1)
Article (Accepted version)
accessLevelRestrictedaccessLevelPublic 04/30/2025
ISSN of the journal0270-9139

Technical informations

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First validation06/12/2024 9:40:40 AM
Update time06/12/2024 9:40:40 AM
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